Trajectories of post-discharge cognitive function and associated risk factors in ICU survivors: a secondary analysis

Cognitive impairment is a significant concern among intensive care unit (ICU) survivors, yet post-discharge cognitive trajectories remain understudied. This study aimed to explore cognitive function trajectories and associated factors in ICU survivors after hospital discharge. This secondary analysis used data from a prospective post-ICU cohort established in Busan, South Korea. A total of 329 ICU survivors who completed cognitive assessments at both early and late follow-up were included. Cognitive function was measured using the Montreal Cognitive Assessment. Approximately 40% of ICU survivors experienced mild cognitive impairment (MCI) within 12 months. Participants were classified into four groups based on the trajectory of cognitive impairment status: Normal, Recovered, Delayed Onset, and Persistent. Compared to the Normal Group, older age and comorbidities were significantly associated with the Recovered MCI Group. In the Delayed Onset MCI Group, older age, admission through emergency department, and trauma-related admission were determinants. In the Persistent MCI Group, factors included older age, lower education level, comorbidities, and discharge to an extended care facility. Cognitive trajectories may vary among ICU survivors after discharge. Based on our findings, a better understanding of post-discharge cognitive trajectories may help guide long-term monitoring and individualized rehabilitation strategies to improve outcomes in this vulnerable population.